TY - JOUR
T1 - Environmental Tobacco Smoke and Lung Cancer in Nonsmoking Women
T2 - A Multicenter Study
AU - Fontham, Elizabeth T.H.
AU - Correa, Pelayo
AU - Chen, Vivien W.
AU - Reynolds, Peggy
AU - Austin, Donald F.
AU - Williams, Anna
AU - Buffler, Patricia A.
AU - Alterman, Toni
AU - Greenberg, Raymond S.
AU - Liff, Jonathan
AU - Boyd, Peggy
N1 - Funding Information:
ETS, the correlationstudybetween workplacenumber of smokersencounteredduringaworkshift tionandpersonalsamplercubicwasnicotineconcentra¬ (microgramsper meter) 0.62(P<.05)andwithpostshifturinary cotininewas0.63 (P<.05).49 Brunnemann etal50sampledindoorairinbars,restau¬ rants,andtrainsandfoundcarcinogenic tobacco-specific A^-nitrosamines at con¬ centrationsupto23pg/LofA/'-nitroso- nornicotineand29pg/Lof4-(methylnit- rosamino)-l-(3pyridyl)-l-butanone. These settingsserveasworkplacesforemploy¬ eesandsocialsettingsforpatrons.The significantelevatedriskoflungcancerin thisstudyassociatedwithexposuresout¬ sidethehomesuggeststheimportanceof thesesettings,inadditiontospousalETS exposure,intheUnitedStates. Thefindingsofthisstudysupportthe long-termexposure ETSincreasesriskoflungcancerin womenwhohavenever personally used tobacco.Thisincreasedriskismore markedforwomenwhohavealsobeen exposedtoETSduringchildhood. Thisresearchwassupportedby grant CA40095 fromtheNationalCancerInstitute,Bethesda,Md, withadditional support from the Louisiana Cancer andLungTrustFundBoardandtheLouisiana StateUniversityStanleyS.ScottCancerCenter, NewOrleans. Theauthorsaregratefulforthecooperationof alloftheparticipatinghospitalsinthefivestudy areasandthemanyphysicianswhohelpedmake thisstudypossible.TheauthorsalsothankGladys Block,PhD,forherthoughtfulcommentsandsug¬ gestions,particularlyrelatedtodietaryexposures; S.DonaldGreenberg,MD,forthemicroscopicre¬ viewofdiagnosticmaterial;ChristopherPowers, MS,GailSmith,MahboobSobhan,PhD,andWil¬ liamJohnson,MS,forprogrammingandanalytic support;LaurelCederquist,MS,AnnieFung,Judy Goldstein,HelenGregory,andAnneMorseforfield supervision;theAmericanHealthFoundationfor conductingtheurinarycotinineanalyses;andthe dedicatedmedicalrecordabstractorsandinter¬ viewersineachstudycenter.
PY - 1994/6/8
Y1 - 1994/6/8
N2 - To determine the relative risk (RR) of lung cancer in lifetime never smokers associated with environmental tobacco smoke (ETS) exposure. —Multicenter population-based case-control study. —Five metropolitan areas in the United States: Atlanta, Ga, Houston, Tex, Los Angeles, Calif, New Orleans, La, and the San Francisco Bay Area, Calif. —Female lifetime never smokers: 653 cases with histologically confirmed lung cancer and 1253 controls selected by random digit dialing and random sampling from the Health Care Financing Administration files for women aged 65 years and older. —The RR of lung cancer, estimated by adjusted odds ratio (OR) with 95% confidence interval (CI), associated with ETS exposure. —Tobacco use by spouse(s) was associated with a 30% excess risk of lung cancer: all types of primary lung carcinoma (adjusted OR=1.29; P<.05), pulmonary adenocarcinoma (adjusted OR=1.28; P<.05), and other primary carcinomas of the lung (adjusted OR=1.37; P=.18). An increasing RR of lung cancer was observed with increasing pack-years of spousal ETS exposure (trend P=.03), such that an 80% excess risk of lung cancer was observed for subjects with 80 or more pack-years of exposure from a spouse (adjusted OR=1.79; 95% CI=0.99 to 3.25). The excess risk of lung cancer among women ever exposed to ETS during adult life in the household was 24%; in the workplace, 39%; and in social settings, 50%. When these sources were considered jointly, an increasing risk of lung cancer with increasing duration of exposure was observed (trend P=.001). At the highest level of exposure, there was a 75% increased risk. No significant association was found between exposure during childhood to household ETS exposure from mother, father, or other household members; however, women who were exposed during childhood had higher RRs associated with adult-life ETS exposures than women with no childhood exposure. At the highest level of adult smoke-years of exposure, the ORs for women with and without childhood exposures were 3.25 (95% CI, 2.42 to 7.46) and 1.77 (95% CI, 0.98 to 3.19), respectively. —Exposure to ETS during adult life increases risk of lung cancer in lifetime nonsmokers.
AB - To determine the relative risk (RR) of lung cancer in lifetime never smokers associated with environmental tobacco smoke (ETS) exposure. —Multicenter population-based case-control study. —Five metropolitan areas in the United States: Atlanta, Ga, Houston, Tex, Los Angeles, Calif, New Orleans, La, and the San Francisco Bay Area, Calif. —Female lifetime never smokers: 653 cases with histologically confirmed lung cancer and 1253 controls selected by random digit dialing and random sampling from the Health Care Financing Administration files for women aged 65 years and older. —The RR of lung cancer, estimated by adjusted odds ratio (OR) with 95% confidence interval (CI), associated with ETS exposure. —Tobacco use by spouse(s) was associated with a 30% excess risk of lung cancer: all types of primary lung carcinoma (adjusted OR=1.29; P<.05), pulmonary adenocarcinoma (adjusted OR=1.28; P<.05), and other primary carcinomas of the lung (adjusted OR=1.37; P=.18). An increasing RR of lung cancer was observed with increasing pack-years of spousal ETS exposure (trend P=.03), such that an 80% excess risk of lung cancer was observed for subjects with 80 or more pack-years of exposure from a spouse (adjusted OR=1.79; 95% CI=0.99 to 3.25). The excess risk of lung cancer among women ever exposed to ETS during adult life in the household was 24%; in the workplace, 39%; and in social settings, 50%. When these sources were considered jointly, an increasing risk of lung cancer with increasing duration of exposure was observed (trend P=.001). At the highest level of exposure, there was a 75% increased risk. No significant association was found between exposure during childhood to household ETS exposure from mother, father, or other household members; however, women who were exposed during childhood had higher RRs associated with adult-life ETS exposures than women with no childhood exposure. At the highest level of adult smoke-years of exposure, the ORs for women with and without childhood exposures were 3.25 (95% CI, 2.42 to 7.46) and 1.77 (95% CI, 0.98 to 3.19), respectively. —Exposure to ETS during adult life increases risk of lung cancer in lifetime nonsmokers.
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U2 - 10.1001/jama.1994.03510460044031
DO - 10.1001/jama.1994.03510460044031
M3 - Article
C2 - 8196118
AN - SCOPUS:84944658894
SN - 0098-7484
VL - 271
SP - 1752
EP - 1759
JO - JAMA: The Journal of the American Medical Association
JF - JAMA: The Journal of the American Medical Association
IS - 22
ER -